Lee T, Kim E, Ji Y. The mediating effect of
transition shock on the relationship between readiness for practice and
turnover intention of new graduate nurses in South Korea: A longitudinal study.
Nurse Educ Today. 2024 Dec;143:106394. doi: 10.1016/j.nedt.2024.106394. Epub
2024 Sep 5. PMID: 39265275.
ReplyDelete6. Sample Size Used in the Study
The study recruited a moderate-to-large group of new graduate nurses in South Korea, which provided enough participants to perform reliable statistical analysis and mediation testing. The sample size strengthened the validity of the results and allowed for meaningful comparisons over time. However, since the sample was limited to specific hospitals and only included new graduates, it may not fully represent all nurses in different regions or practice settings. Attrition during follow-up was also a potential issue that could have influenced the findings.
7. Limitations of the Article
Several limitations were noted in this study. Because it was conducted only in South Korea, cultural and organizational differences may limit how well the results apply to nurses in other countries. The reliance on self-reported surveys introduces the risk of bias, and the homogeneity of the sample (all new graduates) narrows generalizability. In addition, longitudinal dropouts and unmeasured workplace factors, such as staffing ratios or leadership support, may have affected turnover intention but were not fully captured. Finally, the mediation design shows relationships but cannot confirm causation.
1. What are the Advantages and Disadvantages of the Proposed Recommendations
ReplyDeleteThe Proposed recommendations for nursing schools is to cultivate a supportive learning environment that enhances students’ readiness for clinical practice. For hospitals and clinical managers to implement structured adaptation programs to support new graduate nurses through the transition phase. The advantages of this is having Higher readiness for practice correlates with reduced transition shock and, in turn, lower turnover intentions. Improved retention of new nurses by addressing readiness and transition shock may help stem turnover, alleviating staffing shortages and associated training costs.
The disadvantages, resource and cost implications. Schools may need to invest in simulation labs, enhanced curricula, or faculty training. Hospitals may face staffing and budget pressures to implement structured adaptation programs. Variable effectiveness, which may impact of interventions may differ by institution, culture, and individual; not a one-size-fits-all solution.
2. What are the advantages and disadvantages of implementing these recommendations in your Unit/Hospital
Advantages
1. Reduced turnover and improved retention
Smoother transitions for new nurses can translate into higher morale, reduced turnover costs, and improved responsibility handovers.
2. Better-prepared workforce
Nurses entering clinical practice with higher readiness levels and supported adaptation can deliver safer, high-quality patient care more consistently.
3. Positive organizational culture and morale
Structured support programs demonstrate investment in new staff, fostering a culture of inclusion, mentorship, and professional development.
4. Alignment with evidence and best practices
These strategies directly respond to identified mediators of turnover intention, offering a grounded foundation for change.
Disadvantages/Challenges
1. Resource burden
Implementation may require extra staffing for mentorship, funding for structured programs, and protected time for new nurses and educators.
2. Need for sustained administrative commitment
Programs may falter without ongoing investment and engagement from leadership across nursing education and hospital administrators.
3. Potential variability in outcomes
Effectiveness may depend on local context, nurse educator skills, and institutional readiness for change.
4. Demand for evaluation infrastructure
To ensure programs are effective, systems to monitor readiness, transition experience, and turnover must be established—adding complexity and workload.
Describe the method used by the author in the study
ReplyDeleteThe researchers employed a retrospective longitudinal design, tracking 232 new graduate nurses who remained in the same hospital post-graduation across 54 nursing schools in South Korea. Data were collected via surveys at three time points: two months before graduation (T0), six months after graduation (T1), and one year after graduation (T2). To examine the mediating role of transition shock (measured at T1) in the relationship between readiness for practice (T0) and turnover intention (T2), the authors used Hayes' PROCESS macro Model 4, adjusting for variables like work experience, placement in desired units, and completion of pre-graduation internship.
Was the correct method used? why or why not?
Yes, the chosen method was appropriate. A longitudinal design is well-suited for studying changes over time and establishing temporal precedence, which helps indicate whether readiness for practice influences turnover intention via transition shock. Using PROCESS Model 4 is a robust and standard approach for mediation analysis and supports testing causal pathways while controlling covariates. Surveys at three distinct time points enhance the reliability and depth of the data captured, allowing the authors to observe real-time transitions in perceptions and intentions.
However, being retrospective, the study still relies on self-reported measures and lacks experimental control. While it addresses temporality, it cannot definitively establish causation due to potential unmeasured confounders.
1. Discuss the limitations of the article
ReplyDeleteThe article by Lee et al. (2024) also has some notable limitations. It was conducted with new graduate nurses in South Korea, which may limit how well the findings apply to different cultural or healthcare contexts. The study relied on self-reported survey data, which can introduce bias due to social desirability or inaccurate recall. In addition, while it was longitudinal, the follow-up period may not fully capture long-term turnover trends or the evolving nature of transition shock over a nurse’s career.
2. Was the correct method used? why or why not?
Yes, the method used in the study was appropriate because a longitudinal survey design allowed the researchers to track changes in transition shock, readiness for practice, and turnover intention over time. This design is stronger than a cross-sectional approach for examining mediation effects. The use of validated self-report instruments also supported consistency in measuring key variables. However, relying on self-reported data and a limited timeframe may not fully capture the long-term complexity of nurses’ experiences.
1. Describe the method used by the author in the study.
ReplyDeleteThis study used a retrospective longitudinal design method and utilized data from the New Nurse e-Cohort Panel Study (Lee et al., 2023b). The study followed nursing students for three years starting from their fourth year in nursing school. The purpose of the New Nurse e-Cohort Panel Study is to investigate the factors influencing nursing students' characteristics, as well as the adaptation and employment of new nurses. The first panel study took place from 2020 to 2023, followed by a second panel study from 2021 to 2024 to gather longitudinal data. The present study analyzed data from the first, second, and third waves of the first panel study.
2. Discuss the sample size used in the study.
In this study, the initial survey (T0) involved 842 nursing students. In the second survey (T1), 715 participants responded, with 315 reporting employment at hospitals during the survey period. Of these, 277 new graduate nurses participated in the third survey (T2), and 45 participants were excluded from data analysis due to turnover experience (n = 42) or response errors in career pathways (n = 3). Due to the varying start dates for employment among new graduate nurses, 232 participants with different work periods at each T1 and T2 time point were included in the analysis.
Question 1) What are the advantages and disadvantages to the proposed recommendations in the article?
ReplyDeleteOne advantage of the proposed idea is that it leads to smoother transition into practice for the student since it strengthens their confidence, skills, and overall competency. It would also lead to better patient outcomes since patients are being cared for by better prepared and confident nurses. A disadvantage of this proposal would be that it could add onto the workload of the nursing student as nursing school is already intense. Students may feel strained and stressed from this addition.
Question 2)Discuss the sample size used in the study
For the sample size, the researchers pulled students from 54 different schools in South Korea for a total of 232 participants. Since this included such a large batch of students from a wide batch of schools, the sample size was diverse and plentiful. This method of determination of sample size reduced bias in the choosing of participants.
1. What are the advantages and disadvantages of the proposed recommendations in the article?
ReplyDeleteThe recommendations presented in the study, which emphasize enhancing nursing students’ readiness for practice and establishing structured adaptation programs for new graduate nurses, offer several notable benefits. Such interventions have the potential to mitigate transition shock, strengthen clinical competencies, and reduce turnover intentions, thereby promoting workforce stability and improving the quality of patient care. Furthermore, fostering collaboration between nursing schools and clinical institutions can facilitate adequate professional socialization and bolster peer and supervisory support for novice nurses. Nonetheless, these recommendations are not without limitations, including potential inconsistencies in program quality, resource limitations within healthcare institutions, and challenges in providing individualized support across diverse clinical environments. Additionally, as the study’s sample was drawn exclusively from South Korea, the generalizability of these findings and recommendations to other international healthcare settings may be constrained.
2. Describe the method used by the author in the study.
The study utilized a retrospective longitudinal design to investigate the associations among readiness for practice, transition shock, and turnover intention in newly graduated nurses in South Korea. A total of 232 participants, who graduated from 54 nursing schools and had maintained employment at the same hospital for at least one year, were included in the analysis. Data were collected at three time points: two months before graduation, six months post-graduation, and one year post-graduation, to assess readiness for practice, transition shock, and turnover intention. The researchers employed multiple linear regression analyses and Hayes’ PROCESS macro Model 4 to examine both direct and mediating effects while controlling for relevant individual and work-related variables, such as internship experience, work tenure, and placement in a preferred unit. Standardized, validated instruments, including the Readiness for Practice Survey, Transition Shock Scale, and turnover intention measures, were utilized to ensure the reliability and consistency of longitudinal data collection